HISTORY OF SOME OF THE EFFECTS OF HARD DRINKING.
THE SIXTH EDITION.
By
J. C. LETTSOM,
M.D. F.R.S. AND F.S.A.
LONDON: PRINTED BY W. DARTON AND CO. NO. 55, GRACECHURCH-STREET; AND SOLD BY C. DILLY, IN THE POULTRY.
M.DCC.XCL.
PREFACE.
IN the first volume of the "Memoirs of the Medical Society of London," I described some of the unhappy effects of the too free indulgence of strong liquors. My opinions have been disseminated by insertion into many public prints, both at home and abroad; and I have reason to conclude, have been productive of essential benefit to the community. To render this benefit still more extensive, I have reprinted that part of the original essay, more immediately applicable to the pernicious use of these liquors, to which I have added some farther cautions; and likewise a moral and physical Thermometer, the hint of which was suggested by a friend abroad. It is formed to convey, by a glance of the eye, the sentiments I wish to impress upon the reader.
LONDON, April 1789.
JOHN COAKLEY LETTSOM.
This little Performance was originally printed to give away; but the Demands becoming very numerous, I have applied it to the Benefit of the
PHILANTHROPIC SOCIETY,
institued "for the Prevention of Crimes, and for a Reform in the Manners of the rising Poor."
The general Outlines of the Plan adopted by the Society, are to take miserable and destitute Children from poor depraved Parents, and from the resorts of wicked People, to cloath, feed, and educate them as Orphans; and thus by a total separation from their abominable connections, and a redemption from the lowest depths of distress, to restore them to civil community, to which they were either lost, or known only as its burthens, nuisances, and plunderers.
ALTHOUGH this Society has been but a few months established, there are already placed under the care of proper persons, in hired houses, conveniently situated at HACKNEY, several Children of both sexes, who a few weeks since were inhabitants of the most miserable abodes of vice and want; but are now enjoying the blessings of a new life, heightened by the prospects of acquiring an honourable support by their own industry.
HISTORY OF SOME OF THE EFFECTS OF HARD DRINKING.
AFTER introducing the want of appetite for food arising from the indulgence of drinking strong liquors, I cannot well dismiss the subject, without adverting more fully to its painful influence upon the constitution, which I have observed with more anxiety, as the sufferers are often those of the more delicate part of the female sex, whose habits of intemperance are not unfrequently introduced by those who should have been the guardians of their health.
THE miseries entailed by these indulgences, differ much as to their progress and violence, and even the symptoms vary so much, as to admit of obvious distinctions.
THE
first
I shall notice, as being generally less painful, though equally permanent, are the symptoms more especially attendant on persons who have, early in life, habituated themselves to drink freely of wine of various kinds, and from their situations in life, undergone a change of climate, as from
Europe
to the
Indies,
&c. Punch-drinkers, likewise, have been liable to similar complaints. The first appearance of disease is loss of appetite, which at length is so weakened and vitiated,, that after taking food, before the return of the next meal, a kind of heavy pain of the stomach, with a constriction of the muscles of the abdomen, come on, and with a slight effort, a sweetish, brackish, or acid fluid, is thrown up, and the pain and constriction for a short time subside. For several years in this unhappy state, the patient drags on a life, rendered now and then more supportable, either by renewed potations, or exputations, till at length the bodily and mental powers become impaired: the object grows emaciated, the whole body shrinks; neither swelling nor dropsy appear, though the countenance looks sallow; the region of the liver is not enlarged, and the liver itself seems less than natural: the urine is not very high coloured; the
faeces
are hard and dark-coloured; the stomach will take and retain food, but after receiving it, it is oppressed, and feels tightened or contracted in its dimensions; the patient expresses it, as if it were tied by a straight bandage; the same sensation affects the intestines, and the abdomen suffers such irregular constrictions, as become evident to the external touch, the muscles being drawn into irregular action, the surface of the belly is diversified with protuberances and cavities: sometimes the spasmodic strictures run transversely, and raise this surface like waves of the sea. The pain continues increasing to such excess, that the miserable sufferer is obliged to press against a table or some hard body, to mitigate his distress, till vomiting brings a respite; or he hastens this operation, by thrusting his finger into the throat; and thus relieves himself till the next reception of nourishment, when the same tragedy is repeated. The matter discharged is thin, acrid, sour, sweet, or brackish. Sometimes, instead of constipation, an occasional purging ensues, and mitigates the pain, whilst it subdues the constitution; and after years of misery, the victim slides into a fatal decay; but long before this, the powers of the mind have been debilitated, and its recollection and actions impaired.
THE
second
train of distressful symptoms which I shall relate, more generally succeed the free use of spirits, or of wines with the admixture of spirits, as Madeira; and especially where late hours and illicit amours have been superadded.
THE early symptoms of complaint are, a pain and oppression about the pit of the stomach after eating, or distension from fluids; this pain extends to the breast and shoulders; there are frequent eructations of wind, which seem to burn the throat as they ascend; these symptoms, which are usual in affections of the liver, and particularly in bilious effusions, are at first so trivial, as seldom to alarm the fears of the patient, or he slightly mentions them as symptoms of the gout, whilst he attempts to avert the present suffering, by indulging more freely in the very cause of the mischief, till repeated fillips of raw spirits, or a dilution of the poison, render existence miserable.
THE appetite now totally fails, but an insatiable thirst continues, and if it be not supplied with an exhilarating cordial, the vital spirits instantly flag, and such horrors take place as are dreadful even to a bye-stander; the poor victim is so depressed, as to fancy a thousand imaginary evils; he expects momentarily to expire, and starts up suddenly from his seat; walks wildly about the room; breathes short, and seems to struggle for breath; if these horrors seize him in bed, when waking from slumber, he springs up like an elastic body, with a sense of suffocation, and the horrors of frightful objects around him; at the same time the pain of the stomach continues and augments; the fight of wholesome plain food gives disgust, instead of appetite; drink is his cry; or if hunger is excited, it is after high-seasoned, salt, or acrid nourishment.
AT this time, if a dropsy, or fatal jaundice, do not terminate existence, the legs shrink, are swarthy-coloured like the rest of the body, and sometimes purple spots appear and disappear for many months; the extremities feel sore to the touch, and upon scratching them, exude blood: the thighs likewise shrink; but the body, and particularly about the region of the liver, enlarges, and the hardness of the liver may be frequently traced: the face is nearly copper-coloured, is emaciated, sometimes with little suppurations, which dry and turn scaly; the breath smells like rotten apples, and the
morbus niger,
or vomitings of a fluid like that of coffee-grounds, snatch the patient from complicated misery. Sometimes a purging, or bloody discharges, hasten the catastrophe.
THE
third
train of symptoms to be described, is not consined to age or sex, but is in general more frequently the attendant of the female sex.
THE persons liable to the symptoms, have been those of delicate habits, who have endeavoured to overcome the nervous debility, by the aid of spirits: many of these have begun the use of these poisons from persuasion of their utility, rather than from the love of them: the relief, however, being temporary, to keep up their effects, frequent access is had to the same delusion, till at length what was taken by compulsion, gains attachment, and a little drop of brandy, or gin and water, becomes as necessary as food; the female sex, from natural delicacy, acquire this custom by slow degrees, and the poison being admitted in small doses, is slow in its operations, but not less painful in its effects.
THE soberer class of tradesmen, also, who occasionally indulge in their sixpenny-worth of brandy and water, gradually slide into the same unhappy habits, and entail upon their constitutions the same misery, which I shall now introduce.
THE first appearance of indisposition very much resembles what has been last described; and under the deception of the gout, the fuel is heaped upon the fire, till the delusion has been too long maintained to admit of retreat: in general, at least, the attachment to the use of spirituous drinks, becomes so predominant, that neither threats nor persuasions are powerful enough to overcome it. The miserable sufferer is so infatuated, as, in spite of locks and keys, to bribe by high rewards the dependent nurse, privately to procure it.
BUT the concluding symptoms are very different from either of the foregoing histories: frequently, indeed, the appetite for food vanishes, but sometimes continues voracious; and, at the same time, whilst the body is costive, and no vomiting ensues, the lower extremities grow more and more emaciated; the legs become as smooth as polished ivory, and the soles of the feet even glassy and shining, and at the same time so tender, that the weight of the finger excites shrieks and moaning; and yet I have known, that in a moment's time, heavy pressure has given no uneasiness. The legs, and the whole lower extremities, lose all power of action; wherever they are placed, there they remain till moved again by the attendant; the arms and hands acquire the same palsied state, and the patients are rendered incapable of feeding themselves. Thus for years they exist, with no material alteration in the size of the body, or aspect of the countenance.
WHETHER they really undergo the agonies they appear to suffer, I much doubt, as at this period their minds appear idiotish: they often shriek out with a vehemence that may be heard at a considerable distance, but upon enquiring about the seat of pain, they have been vague and indecisive in their answers. When a cramp comes on the lower extremities, involuntary motions draw up the legs, and produce the most piercing shrieks: and the features of the face, altered by convulsive twitchings, excite pain in a spectator. For some months before they die, these shrieks are more incessant, and as violent as the strength will admit.
THEY talk freely in the intervals of mitigation, but of things that do not exist; they describe the presence of their friends, as if they saw realities, and reason tolerably clear upon false premises.
MOSTLY before they die, they take less food; sometimes a purging succeeds, of a thin substance, and of a dark green colour; sometimes a vomiting of black matter; but most generally they gradually sink from the accumulation of pain and debility. There is rarely any fever. They do not, as in the preceding state, fall into dropsies, but usually become paralytic: the breath is not offensive, nor is there the same difficulty of breathing, or horror of suffocation: whether the imperceptible and gradual augmentation in the use of spirits, is the cause of this difference, I am not certain; but the difference is considerable, as must appear from their histories, which I have drawn from actual observation.
I WOULD not, however, infer, that every spirit-drinker acquires the symptoms of disease above related, or that other diseases do not more frequently succeed this dangerous habit: liver diseases, of various kinds, it is well known, usually result from intemperance, and dropsies often succeed; but from some circumstances in the constitution, or from the mode of indulgence in liquors, the symptoms I have described have severally occurred where no dropsical affections have supervened. There is something in sprituous liquors, so injurious to the human frame, that too much attention cannot be paid in discouraging the use of them. Many of the unhappy victims I have attended, ascribe their sufferings to the unguarded advice of some medical practitioner, who has, under the idea of wine turning sour on the stomach, permitted a little drop of brandy and water to be substituted; seldom, indeed, a day passes without introducing me to the sick bed of some deluded object of misery; and it is from the most decided conviction of the injury, that I would guard every person from beginning with even a little drop of this fascinating poison, which once admitted, is seldom, if ever, afterwards overcome. Whenever I hear the patient plead for some substitute for beer or wine, under the supposition of their turning sour, my fears are alarmed, and my endeavours excited, to pluck the unsuspicious patient from the brink of destruction; this plea is never made, till the exhilarating influence of spirit has been experienced; and not a moment should be lost, in warning such objects of their danger.
SOME, who avoid brandy, have been induced to take rum, from a vulgar opinion, that it is more oily and balsamic; the argument is erroneous, for what balsamic qualities can empyreumatic oil contain? Others, who condemn both brandy and rum, make no objection to gin, because they think it diuretic; but so far from it, that half the dropsies among the lower classes of the people originate, or, at least, are confirmed by the use of this spirit; they are all poisons, and are nearly alike deleterious.
WHEN the effects of spirits on the constitution, have not greatly contaminated it, beyond the frequent recurrence of sickness and vomiting; after interdicting spirits altogether, the patient should be allowed to fix upon some one species of nutriment; and, whatever it is, should be confined to it alone, and that in the smallest quantities possible, and at regular stated distances, that the preceding portion may be properly digested, before any addition be allowed: when the stomach has thus acquired more tone, either some new, or an increase of the former nutriment, may be admitted.
I ONCE attended a lady, who could not retain any food on the stomach above an hour or two. I requested her to fix upon some light nourishment that she could palate, and she mentioned milk: I then restrained her to four table-spoonfuls of it every six hours, and afterwards increased the quantity as the stomach could bear it. From this she went to broth, and thus gradually acquired such a state of the stomach, as to bear the usual food of the family; and for four years past she has enjoyed good health, with the moderate use of a glass of wine, or beer, but not one drop of spirits.
BUT in some cases, where the habit of drams has been long continued, the total and sudden omission of them, has sunk the person into irretrievable debility. Here this pernicious custom must be left off gradually. A man who usually drank twelve drams a day, being convinced of his approaching misery, took the resolution to wean himself from this poison; he always drank out of one glass, into this he daily dropped a drop of sealing-wax; by this means he had twelve drops less of spirit every day, till, at length, his glass being filled with wax, his habit was cured.
THE same advantage has been obtained, by taking the dram, or glass of cordial, out of a quart bottle, which is to be replenished each time with as much water, and by this means gradually diluting the remaining liquor, till its strength becomes wholly subdued, and little more than the substituted water remains.
PAINFUL indeed is this truth, that when the indulgence in spirituous liquors is rendered habitual, it is extremely difficult to overcome. Although the miserable object is persuaded, that it clouds his reason, debilitates his mental as well as corporeal faculties, debars him of all the cheerful gratifications annexed to health and virtue; yet so excessive are the debility and tremors of the body—and so horrid is the despondency of the mind after the exhilarating effects of these liquors have subsided, that without a perseverance in determined efforts to vanquish this habit, a repetition of the delusive poison will be indulged, till resolution is too transient and weak to enable the victim to stop at the precipice, which terminates his painful existence.
MAY such, however, as have strength of resolution to reflect upon their danger, be encouraged, by an assurance, that however great the debility may feel, and strong the idea of dissolution may appear, yet from mere debility alone, life is not in danger; and this is a certain fact, that the longer and more frequently the evil habit is resisted, that habit becomes less powerful, whilst the strength of the constitution proportionally augments, and thereby renders the victory less difficult than might at first appear; and what exertions are more interesting and worthy of a rational being, than those which substitute vigour and health of body, for agitation, tremor, and pain; and serenity and cheerfulness of mind, for horror, despondency, and suicide?
A MORAL AND PHYSICAL THERMOMETER; OR, A SCALE of the Progress of TEMPERANCE and INTEMPERANCE.
LIQUORS, with their EFFECTS, in their usual Order.
 
TEMPERANCE
70
WATER;
Health, Wealth,
Serenity of Mind,
Reputation, long Life, and
Happiness.
60
Milk and Water;
50
Small Beer;
40
Cyder and Perry;
Cheerfulness,
Strength and,
Nourishment, when taken only at meals, and in moderate Quantities.
30
Wine;
20
Porter;
10
Strong Beer:
 
INTEMPERANCE
0
 
VICES.
DISEASES.
PUNISHMENTS.
10
Punch
Idleness;
Peevishness;
Quarrelling;
Fighting;
Lying;
Swearing
Obscenity;
Swindling;
Perjury;
Burglary;
Murder;
Suicide.
Sickness;
Puking, and
Tremors of the Hands in the Morning;
Bloatedness;
Inflamed Eyes;
Red Nose & Face;
Sore and swelled Legs;
Jaundice;
Pains in the Limbs, and burning in the Palms of the Hands, & Soles of the Feet;
Dropsy;
Epilepsy;
Melancholy;
Madness;
Palsy;
Apoplexy;
DEATH.
Debt;
Black-Eyes;
Rags;
Hunger;
Hospital;
Poor-house;
Jail;
Whipping;
The Hulks;
Botany Bay;
GALLOWS.
20
Toddy & Crank;
30
Grog,
and Brandy
and Water;
40
Flip and Shrub;
50
Bitters infused in Spirits;
Usquebaugh;
Hysteric Water;
60
Gin,
Anniseed,
Brandy,
Rum,
and Whisky in the
Morning.
70
Do. during the
Day
and
Night.